• Korean Journal of Adult Nursing
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• v.28 no.3
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• pp.302-313
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• 2016

Purpose: The objective of this study was to identify factors related to self-care adherence in symptomatic patients with heart failure (HF). Methods: Using a cross-sectional design, a convenience sample 209 outpatient clinic patients were recruited at two medical centers. Between October 2011 and August 2012, data were collected using the structured questionnaire. Factors related to self-care adherence were examined using hierarchical multiple regression. Results: Mean age of participants was 67.71 years and a half of them (53.6%) were female. They showed relatively low self-care adherence with mean scores of $61.88{\pm}12.92$. Lower self-care adherence was reported in asking for low sodium items, weighing oneself, checking for ankle edema, and exercising for 30 minutes. The overall model significantly explained 23.9% of variance in self-care adherence. Among the predictors, education, New York Heart Association functional classification, and social support were statistically significant in influencing self-care adherence. The variable of negative emotional status such as anxiety and depression were not found to be significant. Conclusion: These findings demonstrate that social support could help self-care adherence among symptomatic patients with HF. Thus, programs targeting self-care adherence in this population should consider the strategies improving social support.

• Korean Journal of Adult Nursing
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• v.23 no.3
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• pp.244-254
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• 2011

Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.

• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.242-250
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• 2015

Purpose: To evaluate heart failure knowledge and adherence to self-care behaviors, and to identify factors affecting adherence to self-care behaviors among Korean patients with heart failure. Methods: Correlational research using the European Heart Failure Self-care Behavior Scale, the Duke Activity Status Index, the Dutch Heart Failure Knowledge Scale, the New York Heart Association Functional Classification, and the Medical Outcomes Study Social Support Survey was conducted. A total of 280 outpatients with heart failure responded to the five questionnaires. Results: The mean scores for self-care adherence and heart failure knowledge were $31.98{\pm}6.81$ and $8.78{\pm}2.53$, respectively, indicating lower adherence and knowledge than those previously reported. Subjects with lower functional status, more social supports, and greater knowledge of heart failure are more likely to adhere to prescribed regimens. Conclusion: Nurses should focus on patient education and support to improve their adherence to self-care behaviors.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.51-64
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• 2013

Purpose: This study was to analyze adherence to self-care behaviors and identify factors affecting the adherence behaviors among inpatients with heart failure. Methods: A total 94 hospitalized inpatients from three hospitals participated in a survey. Data were collected using structured self-reported questionnaire from November 28, 2011 to March 31, 2013 and analyzed using frequency, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression. Results: The score of adherence to self-care behaviors among inpatients with heart failure was $26.02({\pm}8.84)$. Factors related to the adherence to self-care behaviors were living with spouse (t=-2.47, p=.019), functional state (t=2.18, p=.034), heart failure knowledge (r=-.49, p<.001), social support (r=-.35, p<.001), self-control (r=-.25, p=.016), and self-care confidence (r=-.24, p=.019). The factors affecting adherence to self-care behaviors were heart failure knowledge, self-care confidence, and social support. These factors explained 32% of the variance in adherence to self-care behaviors. Conclusion: The adherence to self-care behaviors with heart failure can be improved if heart failure knowledge, self-care confidence, and social support are improved. Therefore, developing a nursing intervention program for patient with heart failure that is considered these factors leads to improve quality of life and prevent readmission.

• Korean Journal of Adult Nursing
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• v.23 no.4
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• pp.374-385
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• 2011

Purpose: The purpose of this study was to identify the factors that influence medication adherence and self-care among low-income older adults with hypertension. Methods: A sample of 297 low-income older adults with hypertension was recruited from June 30 to July 30, 2010. Data collection was done using a face-to-face interview with structured questions. The data were analyzed using descriptive statistics, Pearson's correlation coefficient, and path analysis. Results: Subjective health status, duration of hypertension, number of drugs excluding antihypertensives, body mass index, knowledge about hypertension, sense of coherence, benefit, barrier, and self-efficacy were identified as significant predictors. Subjective health status and duration of hypertension, knowledge, depression, and self-care showed direct effects on medication adherence. Depression had the strongest direct influence on medication adherence. Body mass index, benefit, self-efficacy, and depression showed a direct effect on self-care. Sense of coherence was a strong predictor of depression which significantly influenced on medication adherence and self-care. Conclusion: For enhancing medication adherence and self-care, it is suggested that a psycho-education program reducing depression and increasing knowledge about hypertension should be provided into low-income older adults with hypertension.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.277-286
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• 2011

Purpose: This study examined levels of stress and adherence to self care guidelines in elementary and middle school students who were infected with the influenza A (H1N1) virus in 2009. Method: A total of 649 students from J city participated in the survey. Stress was measured with the Impact of Event Scale-Revised which was developed by Weiss and Marmar (1997) and translated by Eun and colleagues (2005). Adherence to self care guidelines was measured with the scale developed by the authors based on the self care recommendations from Korea Centers for Disease Control and Prevention. Result: Levels of stress and adherence to self care guidelines were higher in elementary school students. However, the severity of participants' stress was less than moderate. The adherence level was significantly different depending on status of taking an antiviral agent, health education and self care education regarding the virus infection. Conclusion: Findings suggest that effects of health education under the national crisis situation due to influenza A (H1N1) virus pandemic were helpful. More in-depth study is needed to understand and to improve middle school students' self care behaviors.

• Journal of Korean Clinical Health Science
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• v.1 no.1
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• pp.19-27
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• 2013

Purpose. To investigate the effects of a video education program on anxiety, pain, adherence to self care of knee arthroscopy surgery. Methods. The data were collected from July to October 2012. The participants were 25 people in the experimental group and 25 in the control group. The video education, which was 30 minutes in length, was shown before operation day using a CD. Results. In the experimental group, adherence to self care increased significantly, and anxiety, VAS is not significantly compared to the control group. Conclusions. It has been confirmed that video education program has positive effects on adherence to self care for patients following arthroscopy surgery.

• Research in Community and Public Health Nursing
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• v.27 no.4
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• pp.370-379
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• 2016

Purpose: The aim of this study was to evaluate the level of self-care adherence in the elderly with diabetes mellitus (DM) who have lived alone, and to investigate the association between health literacy, diabetic knowledge and self-care adherence. Methods: Descriptive research using the cross-sectional approach was conducted. Data was collected by using a convenience sampling of 201 participants who aged sixty-five years old or more and have lived alone. Statistical analysis was conducted by using an independent t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficient and stepwise multiple regression analysis. Results: Mean scores of health literacy, diabetic knowledge and adherence of self-care were $4.41{\pm}3.54$ points out of a possible $12, 6.22{\pm}2.55$ points out of a possible $15, 58.56{\pm}17.28$ points out of a possible 112, respectively. Adherence of self-care showed a statistical association with health literacy (r=.26, p<.001) and diabetic knowledge (r=.30, p<.001). Statistically significant factors in the regression model were monthly income, diabetic knowledge and exercise. Conclusion: The level of self-care adherence in the elderly with diabetes living alone was relatively low. Diabetic knowledge was an important factor to improve the level of self-care adherence for the elderly with diabetes living alone.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.1
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• pp.6-15
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• 2012

Purpose: The purposes of this study were to identify the level of health literacy and to determine its impact on disease-related knowledge and adherence to self-care in adults with hypertension. Methods: This was a cross-sectional, descriptive study in which patients with hypertension were recruited from outpatient hypertension clinics in Seoul, Korea from December, 2009 to February, 2010. A total 186 patients completed series of questionnaires to assess health literacy, disease-related knowledge, and adherence to self-care. Hierarchical linear regression was used to determine whether health literacy was associated with disease-related knowledge and adherence to self-care. Results: Seventy-one (38.2%) and seventy-two (38.7%) patients had inadequate and marginal health literacy, respectively. In hierarchical linear regression, health literacy independently predicted disease-related knowledge (${\beta}$= .43, p < .001) and adherence to self-care (${\beta}$= .37, p < .001) after controlling for age, education level, having a job or not, and body mass index. Conclusion: These findings show that health care providers need to pay attention to patients with hypertension who have inadequate health literacy. Further, it is recommended to develop and implement new strategies for assessing health literacy in clinical practices. Interventions to improve health literacy could promote disease-related knowledge and adherence to self-care in patients with hypertension.

• Journal of Digital Convergence
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• v.15 no.3
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• pp.259-266
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• 2017

The purpose of this study was to survey the effects of convergence factors and time elapsed after kidney transplantation on self-care adherence. The study included 235 patients; the data was collected from September, to October, 2014. Old age, female gender and duration of transplantation were identified as factors significantly affecting self-care adherence. Self-care adherence also showed significant differences depending on the elapsed time, and the decrease in self-care compliance was most evident between 1 and 5 years after kidney transplantation. Therefore, development of a nursing strategy that would provide education and self-care improvement programs is needed to improve self-care based on convergence factors and elapsed time.